Insight: Asylum seekers at breaking point as trauma takes its toll on mental health

Asylum seekers have a high incidence of mental health issues – and a ‘hostile environment’ policy at the Home Office only adds to their trauma. Dani Garavelli hears some of their stories.

A few weeks ago, Vigneswaran Nagamuththu was reunited with his wife and two sons for the first time since he fled Sri Lanka in 2009. It was a happy ending of sorts; after nine years when he feared he might never see them again, they are now all living together in Glasgow. But his joy was tempered by the fact the younger of the two boys, now aged 14, did not recognise him. “I heard him ask his mum, ‘Is this my dad?’” Nagamuththu says. “I left him when he was three years old. He didn’t remember anything at all.”

The former member of the Liberation Tigers of Tamil Eelam (LTTE) is talking to me in the office of immigration solicitors McGlashan MacKay. It is located in an impressive Argyle Street building, its entrance flanked by huge stone men stooped under the weight of the balcony on their shoulders. Nagamuththu knows how that feels; he too has been bent out of shape by the burden he carries; the burden of war, of torture, of exile and separation; but also the burden of having to navigate an often Kafkaesque asylum system which compounds rather than alleviates existing trauma.

With two years’ leave to remain, he could now work, but his mental health is too poor. Though he has had counselling through the organisation Freedom From Torture, he still suffers flashbacks and anxiety.

Nagamuththu’s story is long and complicated; but it is worth telling in detail because it encompasses so much of what those seeking refugee status in the UK have to endure and how it impacts on their mental health.

In Sri Lanka, he had a happy life, he tells me, living under the control of the LTTE. All of his family belonged to the militant group. Two of them died fighting for “the cause”; another worked as a bodyguard for the son of the leader Velupillai Prabhakaran.

I knew if I was sent back to Sri Lanka, I would be killed so I decided to kill myself

But when the civil war ended in May 2009, he surrendered to the Sri Lankan forces and was taken to a “welfare camp” where he was tortured; as, one by one, he watched his friends disappear, he realised he had to get out, so he bribed the authorities and fled.

After travelling through several other countries, he arrived in London in 2010, claimed asylum and was “dispersed” to Glasgow. His time here has been a litany of interviews, court hearings, rejections, appeals and tribunals interspersed with suicide attempts and a period in a mental hospital.

“When I was back home my experience was very terrible,” he tells me through an interpreter. “I was helping transport people to the medical facilities. I saw so many bodies. When I stayed on my own, all these thoughts would come and disturb me. I would cry and cry – sometimes I think it would be better dying than living.”

Despite the torture, his brother’s job and his wife’s testimony that the authorities were still looking for him, the Home Office remains unconvinced he would be at risk if he returned.

Majdi Zalaf, 23, says he felt so supported when he came to Glasgow, he wants to give something back. Picture: John Devlin

At one point, he was sent to a detention centre near Heathrow, ready for removal. “I knew if I was sent back to Sri Lanka, I would be arrested and killed so I decided to kill myself,” he says. “I banged and banged my head against the wall until it was swollen and they gave me an injection. Then they had no choice but to release me.”

Thanks to the efforts of his solicitor Euan MacKay, he was eventually given temporary leave to remain under the European Convention on Human Rights (he is safe for the next two years). Once he has been here ten years, he is likely to be granted indefinite leave to remain, at which point – subject to financial considerations – he would be allowed to bring his family over; but by then his elder child would have been 18 and ineligible.

So his solicitors made an application outside the rules citing his right to private and family life and his mental health and won on appeal. He has lodged a fresh asylum application for refugee status and is now again awaiting a decision.

For years, Nagamuththu has been getting psychological support from Freedom From Torture, but he still suffers from anxiety heightened by the financial strain of having to support his family, who have no recourse to public funds, on his meagre benefits. “Since she has come here, my wife will ask me, ‘Why are you not in bed? But I am not sleepy. I am wide awake, thinking, thinking,” he says.

Rajeswaran Sinnathurai, who once dreamed of being a teacher or a banker, has undergone treatment at the Anchor Centre ' NHS Greater Glasgow and Clyde's Psychological Trauma Service, which deals with the most severe cases. Picture: John Devlin

Alongside Nagamuththu is Sinnahurai Rajeswaran, also from Sri Lanka. He tells his story chronologically and in forensic detail, as if I might be trying to catch him out, a legacy no doubt of having been interrogated by sceptical Home Office officials.

A one-time driver with the LTTE, he spent four years in a succession of camps, where he was beaten, burned with cigarette butts and had a bag placed over his head to suffocate him. Once released, he continued to be harassed, until his uncle helped him flee the country. He arrived in Glasgow in April 2014 and immediately claimed asylum.

The Home Office took until March 2017 to make any decision, initially rejecting his claim as a result, MacKay says, of medical evidence having been mislaid. When it was located, the Home Office withdrew its decision citing “new medical evidence”. He is living on £35 a week and awaiting a fresh judgment.

Rajeswaran, who once dreamed of being a teacher or a banker, has undergone treatment at the Anchor Centre – NHS Greater Glasgow and Clyde’s Psychological Trauma Service, which deals with the most severe cases. “I am very much affected mentally. I have nightmares,” he says. “I miss my family. My father has been in touch with me to say, ‘I want to see you’ – but what can I do? I am now 39 years old and I no longer have any hope of a family life.”

According to the Mental Health Foundation, asylum seekers are five times more likely to have mental health problems than the general population and more than 61 per cent will experience serious mental distress. At the Anchor Centre, a team of psychologists work with those suffering complex PTSD.

“These are people who have often suffered multiple human rights abuses in their countries of origin, including torture and sexual violence, people who have had further traumatic, experiences on their way here, people who may have been exploited by others or trafficked as part of the process as well,” says Rachel Morley, clinical psychologist and lead for asylum seekers and refugees affected by trauma.

When they finally reach the UK, they suffer the dislocation of arriving in an alien land and are further disempowered by being dispersed, without choice, to a city they may never even have heard of. Though they will be given housing and some help to access services, they are likely to be missing home and worrying about extended family members who are still trapped there.

On top of this, they have to navigate a labyrinthine and incoherent asylum process. Since the Windrush scandal broke, there has been much talk about the government’s “hostile environment” policy – an attempt to make life as tough as possible to disincentivise people from coming here – but even so, hearing about it first-hand is shocking.

According to Morley, adversarial Home Office interviews can trigger memories of interrogations in country of origin. Those who are detained suffer even more egregiously, particularly if – like the Sri Lankans – they have been held in camps or prisons at home. Figures published this year showed at least one person a day was self-harming in UK detention centres.

As the level of proof required rises, the process becomes ever more stressful. Already traumatised men and women are asked to produce large quantities of documents they may no longer possess to back up their stories and recall their journeys in mind-boggling detail.

“They will be questioned on every single aspect of their story,” says Eileen Brady, interim clinical services manager at Freedom From Torture. “To give you an example: I travelled up from Newcastle this morning. If they were questioning me, I might produce a train ticket, and that might count as partial proof, but I could have picked it up from the station floor.

“So they would ask how many times my ticket was checked and by whom. They would ask me to tell them all the names of the shops I saw on the way to the station. I have lived in Newcastle for 18 years and I don’t think I could do that.”

Nor are her clients’ scars accepted as proof of torture. “Nowadays the Home Office will ask for additional information, additional information, additional information.

“At what point do you actually say ‘no’, because you provide more reports and more reports and your client has to go through all that and sometimes it’s to no effect anyway.”

Other pressures on asylum seekers include destitution, which often occurs in the period between the rejection of an application and the lodging of an appeal or fresh application. In recent weeks, fears of extreme poverty have been heightened by an announcement by Serco, the company that houses Glasgow’s asylum seekers, that they planned to summarily evict 331 people whose accommodation the Home Office have ceased to fund.

The roll-out of lock changes, now on hold pending a legal challenge by Govan Law Centre, has sparked mass panic amongst asylum seekers and worries amongst those third sector organisations who will be left to pick up the pieces.

Compounding this are the delays in processing many applications. “I remember someone came to see me who had been waiting for nine-and-a-half years,” says MacKay. “We took him on and he got a decision at ten years. At that point, he was given refugee status. So you have to wonder: if the evidence was [always] there to grant refugee status, why did he have to wait ten years?”

There seems to be no rationale as to why one case is processed more quickly than another. “Sometimes there’s a long delay to get to the first decision, whereas other cases will come in and be dealt with in a pretty timely fashion. It almost seems to me there are internal targets and if someone goes outwith that they get put to the side.

“But the Home Office is generally under-resourced, there are delays everywhere not just in asylum applications. We joke about the Croydon [HQ of the UK Border Agency] black hole because you write and get nothing back.”

It is this uncertainty that most depresses Samira*, who fled Algeria to escape an abusive arranged marriage; she has been in the country since January, underwent her Home Office interview three weeks ago and has no idea when a decision will be reached. “I see a psychologist once a week and I am so, so scared. I lie awake at night and think that 99 per cent they will send me home. But I had a terrible life there from the violence. It is a strict country where the men, they are everything. And women just have to obey.”

Helping those from other countries with their mental health problems is fraught with challenges. There is the language barrier, of course; working through interpreters is not ideal. But there are also cultural barriers.

Many countries do not perceive mental health in the same way we do, and in others it still carries an enormous stigma. Before therapists can communicate with asylum seekers they have to understand those differences.

Freedom From Torture tries to use the same interpreters for the same clients, so they grow to know and trust each other. Alongside therapists who work with single adults, families and unaccompanied children, it has a healing neighbourhoods programme which includes a therapeutic garden in the ruins of the Caledonian Church in Glasgow. It is currently working with 50 asylum seekers and refugees – 70 when you take into account their families.

At the last count, the Anchor Centre was seeing upwards of 300 asylum seekers and refugees a year. But both services are hard-pressed. Morley concedes some people have to wait longer than she would want to be seen while Brady says her organisation has turned away more than 30 people since January.

Morley also says sometimes it’s hard to focus on the therapeutic work because people need help with their basic needs, such as food and accommodation. She believes that, while individual charities and third sector organisations are working hard to alleviate poverty and support integration, what the city needs is a dedicated support and advocacy service for asylum seekers.

At the Mental Health Foundation (Scotland) in George Square, Amal Azzudin – herself a refugee and one of the famous Glasgow Girls, who led the dawn raids in the mid 2000s – is showing me pictures painted by some women she has worked with.

One of them shows a woman and her children sheltering under a tree with “only one leaf of hope left on it”. The same painting also features the postman the artist hopes will deliver her leave to remain letter.

After a study found 57 per cent of newly arrived asylum-seeking women in Glasgow showed symptoms of PTSD, Azzudin started an eight-week conversation programme that brought some of them together to talk. “It’s amazing how slowly they begin opening up. Usually we have tears at some point. I think it’s important for them to realise they can’t keep it in,” she says.

One mother cried because her daughter had passed all her Highers, but couldn’t go on to university (as she would have had to pay the fees); another was distressed because her son had been unable to take up the offer of a contract with a football club.

This is another iniquity of the system: that asylum seekers cannot work other than in exceptional circumstances; it’s a waste of their talents and skills, says Azzudin, and it means they have more time on their hands to brood on their problems.

Her conversations will soon be expanded to include programmes for men and young people. The Mental Health Foundation (Scotland) also runs a scheme whereby mentors work with professionally-qualified asylum seekers so they will have something to show employers when they gain refugee status and has recently recruited 12 refugees to act as mental health advocates in the community. Majdi Zalaf, 23, who came here from Syria, is ideally placed to understand the kinds of emotions they are experiencing. “I have one friend, his mum is still in Syria,” he says. “He is a very active person, he is chair of lots of organisations, but he thinks always of his mum. Sometimes he tries to forget her. Once he forgot her for five days but she comes back to him when he sees her number come up on his phone.” Zalaf says he felt so supported when he came to Glasgow, he wants to give something back.

Everyone has good things to say about the welcome Scotland has given them; but with the best will in the world, charities and communities can only do so much. “One of the things I stress is that our asylum system is not going to change,” Azzudin says. “You need to find ways to manage your mental health and try to fight for your case as much as possible.”

Samira’s name has been changed.

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